In spite of many advances in the field of dental resin composites, polymerization shrinkage continues to be a major problem. Shrinkage creates stresses within the material and its interface leading to marginal failure, staining, secondary caries, restoration displacement, tooth fracture, and postoperative sensitivity. The aim of this review is to explain the factors affecting shrinkage stresses, their consequences, and clinical strategies for their management. Clinical SignificancePolymerization shrinkage stress in dental composites is recognized as a significant material limitation that substantially complicates the placement of restorations. Shrinkage creates stresses within the material and its interface leading to marginal failure, staining, secondary caries, restoration displacement, tooth fracture, and postoperative sensitivity. This review explains the factors affecting shrinkage stresses, their consequences, and clinical strategies for their management.